髓心减压加打压植骨术后再次减压法治疗早期股骨头坏死

摘要

Objective :Observation designed pith small incision decompression and suppression of bone graft surgery a-gain drilling decompression surgical treatment the curative effect of early avascular necrosis .Methods :From September 2009 to December 2012 ,selected Steinberg stages :Ⅰ period ,Ⅱ period of 13 patients with unilateral or bilateral necro-sis of the femoral head (16 hips) ,preoperative Harris scoring (65 .35 ± 10 .27) ,in accordance with the established pro-cedure operation ,postoperative bed full 6 weeks ,6 weeks not weight-bearing walk on crutches ,half a year later turn gradually abandon walk normally .Results :Postoperative hip joint pain relief is apparent in the three days ,12 months after X line piece shows no dead zone ,were no collapse of femoral head ,postoperative function Harris hip score 12 months (91 .15 ± 7 .28) ,preoperative surgery has significant difference statistically significant (P<0 .05) .Conclusion:Pith small incision decompression and suppression of bone graft surgery again drilling decompression surgery treatment of early avascular necrosis of treatment method to relieve pain quickly ,with late postoperative weight-bearing principle can obviously prevent femoral head necrosis deformation ,effective guarantee of joint function ,return to normal life .%　　目的：观察自行设计小切口髓心减压加打压植骨术后再次钻孔减压术式治疗早期股骨头坏死的疗效。方法：2009年9月-2012年12月选取Steinberg分期：Ⅰ期，Ⅱ期单侧或双侧股骨头坏死的患者13例（16髋），术前 Harris评分（65．35±10．27），按既定术式手术，术后卧床满6周，6周后拄拐不负重下地行走，半年后逐步弃拐正常行走。结果：术后3d明显出现髋关节疼痛缓解，术后12个月X线片显示无坏死区进展，股骨头均无塌陷出现，术后12个月髋关节功能 Harris评分（91．15±7．28），术前、术后差异有显著性统计学意义（P＜0.05）。结论：小切口髓心减压加打压植骨术后再次钻孔减压术式治疗早期股骨头坏死治疗方法迅速缓解疼痛，配合术后晚负重原则能明显预防股骨头坏死形变，有效的保证关节功能，恢复正常生活。